System for the determination of glucose in fluids

ABSTRACT

The present invention involves an improved test system for the determination of glucose in aqueous fluids of the type which comprises glucose oxidase, a peroxidatively active substance and chromogen. The improvement involves the use of m-anisidine as a chromogen which permits the semi-quantitative determination of glucose at higher concentrations than is possible with previously used chromogens.

This application is a division of application Ser. No. 233,928, filedFeb. 12, 1981, and now U.S. Pat. No. 4,340,669.

BACKGROUND OF THE INVENTION

The present invention is concerned with a process for thesemi-quantitative determination of the presence of high levels ofglucose in aqueous fluids and with a particular indicator (chromogen)useful in such determination.

The determination of glucose in body fluids, such as urine or blood, isof importance not only in the case of diabetic patients who must controltheir sugar input, but it is also important in those situations in whichthe detection of disease as a public health measure requires thescreening of the urine or blood of large numbers of people. Becauseearly diagnosis and continued control are so important in diabetes, aglucose test, to be of greatest value to the physician in his diagnosisand control of the disease, must be conveniently rapid, simple enough toserve the clinician and sensitive enough to reflect meaningfulvariations in urine or blood glucose.

The use of glucose oxidase, a peroxidatively active substance and achromogen, which is oxidized upon exposure to hydrogen peroxide in thepresence of the peroxidatively active substance, for the detection ofglucose in urine is known. The system involves the formation of hydrogenperoxide by the action of glucose oxidase on glucose: ##STR1## and theresultant oxidation of the chromogen (CR) to its oxidized state (CR*)which is visually detectable by a color change: ##STR2##

The test described above can be used in the determination of a series ofmaterials which react with oxygen and an oxidase resulting in theformation of hydrogen peroxide. Thus, the system is useful for thedetection of occult blood in various body tissues because of the factthat hemoglobin is such a material. Several different chromogens havebeen reported as being useful in the determination method underconsideration. U.S. Pat. No. 3,012,976 discloses the use of o-tolidine,o-toluidine, p-toluidine, o-phenylenediamine,N,N'-dimethyl-p-phenylene-diamine, N,N'-diethyl-p-phenylenediamine,benzidine, p-anisidine, o-catechol and pyrogallol in an occult bloodtest of the type under consideration. U.S. Pat. No. 3,335,069 involves atest for uric acid and describes the use of o-anisidine and p-anisidineas chromogens.

Of the chromogens disclosed as being useful, few have been actually usedin practice. Benzidine was a preferred chromogen, but due to thediscovery that it is a potent carcinogen, it lost favor. The discoverythat 3,3',5,5'-tetraalkylbenzidines were not carcinogens and thepublication of this discovery, led to the obvious expedient of using oneof these compounds as the chromogen in a system of the type describedabove. Such is disclosed in British Patent Specification No. 1,464,359.Page 5 of this specification discloses the observed results witho-tolidine, tetramethylbenzidine and tetraethylbenzidine as chromogen at0, 50, 100, 250, 500 and 1,000 milligram (mg.) % glucose in the fluidbeing tested. Each of these materials turns from yellow to bright greenwhen the concentration of glucose increases from 0 to 50 mg. %. As theconcentration of glucose increases the color of the oxidized chromogendarkens so that the observed colors were olive-black, black and deepgreen, respectively. This observation highlights a problem with thesemi-quantitative determination of glucose in aqueous fluids because athigher concentrations, known chromogens appear black or very dark greenthereby limiting their utility as chromogens in semi-quantitative testdevices. Semi-quantitative determination of glucose in urine when theglucose concentration is high, i.e., from about 2,000 to 5,000 mg. % isespecially important because urine glucose concentrations in diabeticpatients can be as high as 5% or higher. The quantitative estimation ofurine glucose to concentrations of 5% is important for at least tworeasons: (a) High urine glucose concentrations are likely to beassociated with diabetic coma. In emergency situations, it is importantto determine whether a state of unconsciousness is diabetic coma. A stattest of this description, indicating a high urine glucose concentrationwould therefore suggest diabetic coma, (b) Urine glucose levels becomeelevated if an insufficient amount of insulin has been administered. Atest which can estimate higher urine glucose concentrations thereforehas greater utility in the therapeutic monitoring of insulinrequirements.

The use of m-anisidine as a chromogen in reactions involving peroxidesand peroxidase is not reported in the literature. Two references reportthe use of m-anisidine in systems containing peroxide and trace amountsof Cu⁺⁺. They are:

Dolmanova, I. F., et al, "Mechanism of the Catalytic Action of Copper inthe Oxidation of a Series of Organic Compounds by Hydrogen Peroxide."Vestn. Mosk, Univ., Khim 1970, 11 (5), 573.

Krause, F., "Organic Inhibitors Which are Converted Into Active RedoxCatalysts by Trace Amounts of Cu⁺⁺." Oesterr. Chem. Ztg. 68 (2), 54(1967).

It would be desirable, and it is an object of the present invention toprovide an improved method for the detection of glucose in aqueousfluids by the glucose oxidase/peroxidatively active substance system,which method is useful for the semi-quantitative determination ofglucose at concentrations of 2000 to 5000 mg. %.

SUMMARY OF THE INVENTION

The present invention is an improvement to a test composition for thedetermination of the presence of glucose in a liquid test sample. Thetest composition, which comprises glucose oxidase, a peroxidativelyactive substance and a chromogen reactive with hydrogen peroxide whichreaction is catalyzed by the peroxidatively active substance, isimproved by the use of m-anisidine as chromogen.

DETAILED DESCRIPTION AND PREFERRED EMBODIMENTS

For the purpose of this application the term "fluids" shall beunderstood to refer to body fluids, such as blood serum, blood plasma,urine, spinal fluids and, in addition, shall refer to aqueous solutionscontaining urea. Although the most preferred application of the testmeans and process of this invention is to body fluids, such as blood andurine, it should be understood that the disclosed test means and processcan be applied to industrial fluids as well.

The glucose indicator of the invention can be in the form of a treatedpaper, a bottled reagent, a frangible capsule containing the indicatorin reagent form, a pill or tablet which can be dropped into water oralcohol or the fluid being tested for glucose, or a solid alcohol gelcontaining the reagent. When in pill or tablet form the indicator maycontain a heat-generating substance, such as lithium chloride, whichprovides heat when placed in water, thus accelerating the reaction rate.

The preferred glucose indicator is prepared by treating a suitablecarrier matrix with glucose indicator composition in the form of liquidreagent. The expression "carrier matrix" refers to either bibulous ornonbibulous matrices which are insoluble in and maintain theirstructural integrity when exposed to water or other physiologicalfluids. Suitable bibulous matrices which can be used include paper,cellulose, wood, synthetic resin fleeces, woven and nonwoven fabrics andthe like. Nonbibulous matrices include glass fiber and organoplasticmaterials, such as polypropylene and the like. The carrier matrix can besoaked, immersed in, sprayed or printed with the liquid reagentcomposition and the carrier matrix thereafter dried by suitable means,such as ambient or forced air drying to leave the dry reagent/matrixcombination. The matrix can advantageously be affixed to an insolublesupport member such as an organoplastic strip, e.g., polystyrene, bysuitable means, such as double faced adhesive tape, for ease of use.

A typical liquid reagent composition will contain from 1,000 to 1,600international units (I.U) of glucose oxidase per ml., 600 to 1,300 I.U.of horseradish peroxidase per ml., and from 10 to 15 milligrams/ml. ofm-anisidine as chromogen. In a preferred embodiment, a small amount, 0.5to 1.0 milligram/ml., of a second indicator having a high extinctioncoefficient is employed. This is the case because test systems of thetype under consideration using m-anisidine as chromogen givesemi-quantitative readings over the range of 250 to 5,000 mg. perdeciliter (mg./dl.) with color breaks at about 250, 500, 1,000, 2,000and 5,000 mg./dl. The addition of a small amount of a second chromogenhaving a high extinction coefficient provides a system which is capableof detecting the presence of glucose in smaller concentrations, e.g.,100 mg./dl., while possessing the ability to differentiate betweenconcentrations of 2,000 and 5,000 mg./dl. which levels are normallydifficult, if not impossible, to distinguish.

Suitable materials for use as the second chromogen include o-tolidine,benzidine, syringaldazine, diaminofluorine and tetramethylbenzidine.Preferably tetramethylbenzidine is added to provide semi-quantitativesensitivity at low glucose concentrations. Since the glucosedetermination works best at a pH of from about 5.0 to 7.0, a buffer isnormally added to the composition to maintain the desired pH.

Substances having peroxidative activity which are useful in the presentinvention can be chosen from various organic and inorganic sources.Plant peroxidases, such as horseradish peroxidase or potato peroxidase,can be used. Inorganic compounds having peroxidase activity includeiodides, such as sodium and ammonium iodides, and molybdates, such aspotassium and ammonium molybdates. In addition, urohemin and a number ofother prophyrin substances having peroxidative activity can be used.Other substances which are not enzymes, but which have peroxidativeactivity include such compounds as iron sulfocyanate, iron tannate,ferrous ferrocyanide, potassium chromic sulfate and the like.

The invention is further illustrated by the following examples:

EXAMPLE I

An experiment was carried out to demonstrate the improvement inquantification achieved with the use of the indicator m-anisidine in theabove described test device. The experiment was limited to show theimprovement with glucose concentrations of from 2,000 to 5,000(mg./dl.). While the units used in this example are mg./dl. it should benoted that they are equivalent to the mg. % used in the prior art.Strips were prepared from test solutions by impregnating Whatman 31 ETpaper with the liquid reagent composition and drying the treated paperat 50° C. for 15 minutes.

Several test solutions were prepared using the following generalformula:

    ______________________________________                                        Citrate buffer, 2.0 M, pH 5.5                                                                          1.0    ml.                                           Peroxidase (Horseradish),                                                     50 milligrams per milliliter (mg./ml.)                                                                 2.0    ml.                                           Glucose Oxidase (5,000 I.U./ml.)                                                                       3.0    ml.*                                          Polyvinyl Pyrrolidone (15% in ethanol)                                                                 1.9    ml.                                           Emulphor ON-870, 10% ethanol                                                                           0.5    ml.                                           Indicator                0.001  mole                                          Tetrahydrofuran          1.6    ml.                                           Total Volume             10.0   ml.                                           ______________________________________                                         *Lesser amounts of glucose oxidase were used with certain indicators.         Water was added in these cases to bring the total volume to 10 ml.       

Emulphor ON-870 is a nonionic detergent. Its purpose is to providebetter strip wettability which, in turn, provides more uniform colordevelopment.

The number of glucose oxidase units added was varied to meet the needsof each indicator. The room temperature incubation times for theresulting strips were, therefore, varied only between 60 and 90 seconds.The amounts of glucose oxidase were varied to allow each system todevelop approximately the same amounts of color at any given incubationtime. Therefore, those systems using indicators with lower molarextinction coefficients contained correspondingly higher glucose oxidaseconcentrations. This is normally what is done to optimize thequantitation of a test strip composition. If the glucose oxidaseconcentration was held the same for all indicators, strips usingindicators with higher extinction coefficients might develop colors sodark in response to 2% glucose that the 2% and 5% glucose concentrationsmight not be distinguishable.

Reflectance measurements were taken at the optimum wavelength for eachindicator after dipping the strips in either 2,000 or 5,000 mg./dl.glucose in urine. The percent reflectance values for the two glucoseconcentrations were converted to KS values. Reflectance measurements canbe converted to K/S values by the following formula: ##EQU1## where K isthe absorption coefficient of the sample, S is the light-scatteringcoefficient of the matrix, and R is the fraction of incident lightreflected from the reagent pad. This is a simplified version of theKubelka-Munk equation. K/S values are related to reflectancemeasurements as absorbance is to transmittance measurements. These plots(K/S vs. % glucose) provide a more equitable comparison of indicatorshaving different molar extinction coefficients. A plot of K/S values vs.glucose concentrations of 2,000 and 5,000 mg./dl. gave slopes whichprovided a measure of quantitative capabilities of each indicator. Thefollowing table lists the calculated and normalized values for theslopes obtained.

    ______________________________________                                                                    Normalized                                        Indicator           Slope   Value                                             ______________________________________                                        m-Anisidine         0.233   100                                               o-Anisidine         0.057   24                                                p-Anisidine         0.110   47                                                p-Aminosalicylate   0.123   53                                                p-Bromoaniline      0.100   43                                                4-Aminoantipyrene and indole                                                                      0.113   49                                                ______________________________________                                    

The slopes were normalized to assign a value of 100% to the slope form-anisidine. The slopes obtained for the other indicators were thenlisted as percentages of the slope obtained for m-anisidine. Steeperslopes represent better quantitation. The results summarized in thetable show that the difference between the color intensities developedin response to 2% and 5% glucose are substantially greater form-anisidine than for other indicators. The results show that the slopeobtained with m-anisidine was at least twice as great as that obtainedwith several structurally related and structurally dissimilar redoxindicators.

EXAMPLE II

An optimized prototype containing a low concentration of tetramethylbenzidine and m-anisidine was prepared as in Example I using thefollowing ingredients to form a test solution for application to teststrips:

    ______________________________________                                        Citrate Buffer, 2.0M, pH 5.5                                                                        1.0 ml.                                                 Peroxidase, 50 mg./ml.                                                                              2.0                                                     Glucose Oxidase, 5,000 I.U./ml.                                                                     3.0                                                     Polyvinyl Pyrrolidone,                                                        15% in Ethanol        1.9                                                     Emulphor ON-870, 10% in Ethanol                                                                     0.5                                                     m-Anisidine           0.112                                                   Tetramethyl Benzidine,                                                        0.05M in Tetrahydrofuran                                                                            0.5                                                     Tetrahydrofuran       1.0                                                     Total Volume          10.0                                                    ______________________________________                                    

The performance of these strips was evaluated with the use of 56clinical urine specimens. The colors developed by the test strips inresponse to glucose present in these samples was compared to a standardcolor chart with blocks equivalent to 0.0, 100, 250, 500, 1,000, 2,000and 5,000 mg./dl. glucose. The test strips could readily distinguish allthese levels. A correlation plot comparing these results with ahexokinase reference procedure provided a linear regression ofy=1.07X+0.08 and a correction coefficient of 0.93.

What is claimed is:
 1. A test capable of the determination of thepresence of glucose in a liquid test sample which device comprises acarrier matrix which bears the residue left by impregnating it with aliquid reagent solution of solvent, glucose oxidase, a peroxidativelyactive substance and m-anisidine with subsequent evaporation of thesolvent to leave the dry reagent composition wherein the reagentcomponents are present in the carrier matrix in amounts and proportionssuch that the carrier matrix is capable of differentiating betweenconcentrations of 2,000 and 5,000 milligrams of glucose per deciliter.2. The test device of claim 1 wherein the carrier matrix is a bibulousmaterial and the solution contains from 1,000 to 1,600 internationalunits of glucose oxidase per milliliter, 600 to 1,300 internationalunits of horseradish peroxidase per milliliter and from 10 to 15milligrams per milliliter of m-anisidine.
 3. The test device of claim 2wherein the solution contains from 0.5 to 1.0 milligram per milliliterof a second chromogen having a high extinction coefficient.